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Geiker NRW, Astrup A, Hjorth MF, Sjödin A, Pijls L, Markus CR. Does stress influence sleep patterns, food intake, weight gain, abdominal obesity and weight loss interventions and vice versa? Obes Rev 2018; 19:81-97. [PMID: 28849612 DOI: 10.1111/obr.12603] [Citation(s) in RCA: 131] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 07/06/2017] [Accepted: 07/22/2017] [Indexed: 12/29/2022]
Abstract
Decades of research have reported only weak associations between the intakes of specific foods or drinks and weight gain and obesity. Randomized controlled dietary intervention trials have only shown very modest effects of changes in nutrient intake and diet composition on body weight in obese subjects. This review summarizes the scientific evidence on the role mental stress (either in or not in association with impaired sleep) may play in poor sleep, enhanced appetite, cravings and decreased motivation for physical activity. All these factors contribute to weight gain and obesity, possibly via decreasing the efficacy of weight loss interventions. We also review evidence for the role that lifestyle and stress management may play in achieving weight loss in stress-vulnerable individuals with overweight.
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Affiliation(s)
- N R W Geiker
- Clinical Nutrition Research Unit, Copenhagen University Hospital Herlev and Gentofte, Hellerup, Denmark
| | - A Astrup
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - M F Hjorth
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - A Sjödin
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - L Pijls
- Loekintofood-gcv/scs, Brussels, Belgium
| | - C Rob Markus
- Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
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Neuropeptide Y Regulates Sleep by Modulating Noradrenergic Signaling. Curr Biol 2017; 27:3796-3811.e5. [PMID: 29225025 DOI: 10.1016/j.cub.2017.11.018] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 10/11/2017] [Accepted: 11/06/2017] [Indexed: 12/20/2022]
Abstract
Sleep is an essential and evolutionarily conserved behavioral state whose regulation remains poorly understood. To identify genes that regulate vertebrate sleep, we recently performed a genetic screen in zebrafish, and here we report the identification of neuropeptide Y (NPY) as both necessary for normal daytime sleep duration and sufficient to promote sleep. We show that overexpression of NPY increases sleep, whereas mutation of npy or ablation of npy-expressing neurons decreases sleep. By analyzing sleep architecture, we show that NPY regulates sleep primarily by modulating the length of wake bouts. To determine how NPY regulates sleep, we tested for interactions with several systems known to regulate sleep, and provide anatomical, molecular, genetic, and pharmacological evidence that NPY promotes sleep by inhibiting noradrenergic signaling. These data establish NPY as an important vertebrate sleep/wake regulator and link NPY signaling to an established arousal-promoting system.
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Rau HK, Hendrickson RC, Roggenkamp HC, Peterson S, Parmenter B, Cook DG, Peskind E, Pagulayan KF. Fatigue – but not mTBI history, PTSD, or sleep quality – directly contributes to reduced prospective memory performance in Iraq and Afghanistan era Veterans. Clin Neuropsychol 2017; 32:1319-1336. [DOI: 10.1080/13854046.2017.1381277] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Holly K. Rau
- Veterans Affairs (VA) Northwest Network (VISN 20) Mental Illness, Research, Education, and Clinical Center (MIRECC), VA Puget Sound Health Care System, Seattle, WA, USA
| | - Rebecca C. Hendrickson
- Veterans Affairs (VA) Northwest Network (VISN 20) Mental Illness, Research, Education, and Clinical Center (MIRECC), VA Puget Sound Health Care System, Seattle, WA, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - Hannah C. Roggenkamp
- Veterans Affairs (VA) Northwest Network (VISN 20) Mental Illness, Research, Education, and Clinical Center (MIRECC), VA Puget Sound Health Care System, Seattle, WA, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - Sarah Peterson
- Veterans Affairs (VA) Northwest Network (VISN 20) Mental Illness, Research, Education, and Clinical Center (MIRECC), VA Puget Sound Health Care System, Seattle, WA, USA
| | - Brett Parmenter
- Veterans Affairs (VA) Northwest Network (VISN 20) Mental Illness, Research, Education, and Clinical Center (MIRECC), VA Puget Sound Health Care System, Seattle, WA, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - David G. Cook
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
- Department of Pharmacology, University of Washington School of Medicine, Seattle, WA, USA
- Geriatric Research, Education, and Clinical Center (GRECC), Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
| | - Elaine Peskind
- Veterans Affairs (VA) Northwest Network (VISN 20) Mental Illness, Research, Education, and Clinical Center (MIRECC), VA Puget Sound Health Care System, Seattle, WA, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - Kathleen F. Pagulayan
- Veterans Affairs (VA) Northwest Network (VISN 20) Mental Illness, Research, Education, and Clinical Center (MIRECC), VA Puget Sound Health Care System, Seattle, WA, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
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Vargas I, Mayer S, Lopez-Duran N. The Cortisol Awakening Response and Depressive Symptomatology: The Moderating Role of Sleep and Gender. Stress Health 2017; 33:199-210. [PMID: 27465684 DOI: 10.1002/smi.2691] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Revised: 06/08/2016] [Accepted: 06/09/2016] [Indexed: 11/07/2022]
Abstract
The association between depression and the cortisol awakening response (CAR) has been widely examined, yet the results are mixed and factors responsible for such inconsistencies are poorly understood. The current study investigated whether the link between depressive symptomatology and CAR varied as a function of two such factors: sleep and gender. The sample included 58 young adults (30 females; Mage = 18.7; SDage = 0.91). Participants completed the Beck Depression Inventory as well as the Consensus Sleep Diary to assess depressive symptomatology and daily sleep patterns, respectively. Participants also provided four salivary cortisol samples (0, 30, 45 and 60 min after awakening) during two consecutive weekdays. Results demonstrated that greater depressive symptoms were associated with a greater CAR but only when depressive symptoms were linked to a shorter sleep time. In addition, gender significantly moderated the association between depressive symptoms and CAR. While greater depressive symptoms were associated with an elevated CAR among females, they were associated with a blunted CAR among males. These findings provide some insight into potential mechanisms linking depressive symptomatology and CAR, and suggest that future studies examining CAR as a biomarker of depression should account for differences in sleep and gender. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Ivan Vargas
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | - Stefanie Mayer
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
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The Prospective Association of the Diurnal Cortisol Rhythm With Sleep Duration and Perceived Sleeping Problems in Preschoolers: The Generation R Study. Psychosom Med 2017; 79:557-564. [PMID: 28570434 DOI: 10.1097/psy.0000000000000440] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Cortisol, the end product of the hypothalamic-pituitary-adrenal axis, plays an important role in modulating sleep. Yet, studies investigating the association between diurnal cortisol rhythm and sleep patterns in young children are scarce. We tested the hypothesis that the diurnal cortisol rhythm is associated with shorter sleep duration and more sleep problems across early childhood. METHODS This study was embedded in Generation R, a population-based cohort from fetal life onward. Parents collected saliva samples from their infant at five moments during day 1. In 322 infants aged 12 to 20 months, we determined the diurnal cortisol rhythm by calculating the area under the curve (AUC), the cortisol awakening response (CAR), and the diurnal slope. Sleep duration and sleep behavior were repeatedly assessed across ages of 14 months to 5 years. Generalized estimating equation models were used to assess related cortisol measures to sleep duration and sleep behavior. RESULTS The diurnal cortisol slope and the CAR, but not the AUC, were associated with sleep duration across childhood. Children with flatter slopes and children with a more positive CAR were more likely to have shorter nighttime sleep duration (β per nmol/L/h slope = -0.12, 95% confidence interval = -0.19 to -0.05, p = .001; β per nmol/L CAR = -0.01, 95% confidence interval = -0.02 to 0.00, p = .04). Cortisol measures did not predict sleep problems. CONCLUSIONS The present study suggests that a flatter diurnal cortisol slope and a more marked morning rise, which can indicate stress (or hypothalamic-pituitary-adrenal dysregulation), have a long-term association with sleep regulation.
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The effect of working on-call on stress physiology and sleep: A systematic review. Sleep Med Rev 2017; 33:79-87. [DOI: 10.1016/j.smrv.2016.06.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 05/19/2016] [Accepted: 06/02/2016] [Indexed: 11/20/2022]
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Yun S, Wennerholm M, Shelton JE, Bonaventure P, Letavic MA, Shireman BT, Lovenberg TW, Dugovic C. Selective Inhibition of Orexin-2 Receptors Prevents Stress-Induced ACTH Release in Mice. Front Behav Neurosci 2017; 11:83. [PMID: 28533747 PMCID: PMC5420581 DOI: 10.3389/fnbeh.2017.00083] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 04/19/2017] [Indexed: 11/13/2022] Open
Abstract
Orexins peptides exert a prominent role in arousal-related processes including stress responding, by activating orexin-1 (OX1R) and orexin-2 (OX2R) receptors located widely throughout the brain. Stress or orexin administration stimulates hyperarousal, adrenocorticotropic hormone (ACTH) and corticosterone release, and selective OX1R blockade can attenuate several stress-induced behavioral and cardiovascular responses but not the hypothalamic-pituitary-adrenal (HPA) axis activation. As opposed to OX1R, OX2R are preferentially expressed in the paraventricular hypothalamic nucleus which is involved in the HPA axis regulation. In the present study, we investigated the effects of a psychological stress elicited by cage exchange (CE) on ACTH release in two murine models (genetic and pharmacological) of selective OX2R inhibition. CE-induced stress produced a significant increase in ACTH serum levels. Mice lacking the OX2R exhibited a blunted stress response. Stress-induced ACTH release was absent in mice pre-treated with the selective OX2R antagonist JNJ-42847922 (30 mg/kg po), whereas pre-treatment with the dual OX1/2R antagonist SB-649868 (30 mg/kg po) only partially attenuated the increase of ACTH. To assess whether the intrinsic and distinct sleep-promoting properties of each antagonist could account for the differential stress response, a separate group of mice implanted with electrodes for standard sleep recording were orally dosed with JNJ-42847922 or SB-649868 during the light phase. While both compounds reduced the latency to non-rapid eye movement (NREM) sleep without affecting its duration, a prevalent REM-sleep promoting effect was observed only in mice treated with the dual OX1/2R antagonist. These data indicate that in a psychological stress model, genetic or pharmacological inhibition of OX2R markedly attenuated stress-induced ACTH secretion, as a separately mediated effect from the NREM sleep induction of OX2R antagonism.
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Affiliation(s)
- Sujin Yun
- Department of Neuroscience, Janssen Research and Development, L.L.C.San Diego, CA, USA
| | - Michelle Wennerholm
- Department of Neuroscience, Janssen Research and Development, L.L.C.San Diego, CA, USA
| | - Jonathan E Shelton
- Department of Neuroscience, Janssen Research and Development, L.L.C.San Diego, CA, USA
| | - Pascal Bonaventure
- Department of Neuroscience, Janssen Research and Development, L.L.C.San Diego, CA, USA
| | - Michael A Letavic
- Department of Neuroscience, Janssen Research and Development, L.L.C.San Diego, CA, USA
| | - Brock T Shireman
- Department of Neuroscience, Janssen Research and Development, L.L.C.San Diego, CA, USA
| | - Timothy W Lovenberg
- Department of Neuroscience, Janssen Research and Development, L.L.C.San Diego, CA, USA
| | - Christine Dugovic
- Department of Neuroscience, Janssen Research and Development, L.L.C.San Diego, CA, USA
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Henry M, Ross IL, Wolf PSA, Thomas KGF. Impaired quality and efficiency of sleep impairs cognitive functioning in Addison's disease. Psychoneuroendocrinology 2017; 78:237-245. [PMID: 28235729 DOI: 10.1016/j.psyneuen.2017.02.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 02/06/2017] [Accepted: 02/07/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND Standard replacement therapy for Addison's disease (AD) does not restore a normal circadian rhythm. Periods of sub- and supra- physiological cortisol levels experienced by patients with AD likely induce disrupted sleep. Given that healthy sleep plays an important role in memory consolidation, the novelty of the current study was to characterise, using objective measures, the relationship between sleep and memory in patients with AD, and to examine the hypothesis that poor sleep is a biological mechanism underlying memory impairment in those patients. METHODS We used a within-subjects design. Ten patients with AD and 10 matched healthy controls completed standardised neuropsychological tests assessing declarative memory (Rey Auditory Verbal Learning Test) and procedural memory (Finger Tapping Task) before and after a period of actigraphy-measured sleep, and before and after a period of waking. RESULTS Relative to healthy controls, patients with AD experienced disrupted sleep characterised by poorer sleep efficiency and more time spent awake. Patients also showed impaired verbal learning and memory relative to healthy controls (p=0.007). Furthermore, whereas healthy controls' declarative memory performance benefited from a period of sleep compared to waking (p=0.032), patients with AD derived no such benefit from sleep (p=0.448). Regarding the procedural memory task, analyses detected no significant between-group differences (all p's<0.065), and neither group showed significant sleep-enhanced performance. CONCLUSIONS We demonstrated, using actigraphy and standardized measures of memory performance, an association between sleep disturbances and cognitive deficits in patients with AD. These results suggest that, in patients with AD, the source of memory deficits is, at least to some extent, disrupted sleep patterns that interfere with optimal consolidation of previously-learned declarative information. Hence, treating the sleep disturbances that are frequently experienced by patients with AD may improve their cognitive functioning.
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Affiliation(s)
- Michelle Henry
- ACSENT Laboratory, Department of Psychology, University of Cape Town, South Africa; Centre for Higher Education Development, University of Cape Town, South Africa.
| | - Ian Louis Ross
- Division of Endocrinology, Department of Medicine, University of Cape Town, South Africa
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Bartlett DM, Cruickshank TM, Hannan AJ, Eastwood PR, Lazar AS, Ziman MR. Neuroendocrine and neurotrophic signaling in Huntington’s disease: Implications for pathogenic mechanisms and treatment strategies. Neurosci Biobehav Rev 2016; 71:444-454. [DOI: 10.1016/j.neubiorev.2016.09.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 08/29/2016] [Accepted: 09/12/2016] [Indexed: 11/25/2022]
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Perceived stress and its predictors in people with epilepsy. Epilepsy Behav 2016; 62:47-52. [PMID: 27450304 DOI: 10.1016/j.yebeh.2016.06.038] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Revised: 06/27/2016] [Accepted: 06/27/2016] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Perceived stress in people with epilepsy (PWE) is one of the major precipitants for seizures. We investigated the degree of perceived stress in PWE and its predictors. We also aimed to reveal the interrelationships among the predictors. METHODS This was a case-control study. Consecutive patients visiting a tertiary care epilepsy clinic completed self-reported questionnaires including the Perceived Stress Scale (PSS), Revised Stigma Scale (RSS), Korean version of the Neurological Disorders Depression Inventory for Epilepsy (K-NDDI-E), Generalized Anxiety Disorder - 7 (GAD-7), and short forms of the Patient-Reported Outcomes Measurement Information System - Sleep Disturbance (PROMIS-SD) and Patient-Reported Outcomes Measurement Information System - Sleep-Related Impairment (PROMIS-SRI) scales. RESULTS The mean score of the PSS was significantly lower in patients with well-controlled epilepsy (WCE) and higher in those with uncontrolled epilepsy compared with controls. Although several factors including demographic, socioeconomic, psychosomatic, and epilepsy-related factors were associated with the PSS score, the strongest predictor for the PSS score was the K-NDDI-E score, followed by the PROMIS-SRI score, the GAD-7 score, and seizure control. Psychosomatic factors exerted both a direct effect on the PSS score and an indirect effect on the PSS score through seizure control. CONCLUSION Rapid detection and appropriate management of psychiatric and sleep-related problems in PWE may lessen stress and aid in preventing further seizures.
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Zeitzer JM, Nouriani B, Rissling MB, Sledge GW, Kaplan KA, Aasly L, Palesh O, Jo B, Neri E, Dhabhar FS, Spiegel D. Aberrant nocturnal cortisol and disease progression in women with breast cancer. Breast Cancer Res Treat 2016; 158:43-50. [PMID: 27314577 PMCID: PMC4938753 DOI: 10.1007/s10549-016-3864-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 06/09/2016] [Indexed: 02/07/2023]
Abstract
While a relationship between disruption of circadian rhythms and the progression of cancer has been hypothesized in field and epidemiologic studies, it has never been unequivocally demonstrated. We determined the circadian rhythm of cortisol and sleep in women with advanced breast cancer (ABC) under the conditions necessary to allow for the precise measurement of these variables. Women with ABC (n = 97) and age-matched controls (n = 24) took part in a 24-h intensive physiological monitoring study involving polysomnographic sleep measures and high-density plasma sampling. Sleep was scored using both standard clinical metrics and power spectral analysis. Three-harmonic regression analysis and functional data analysis were used to assess the 24-h and sleep-associated patterns of plasma cortisol, respectively. The circadian pattern of plasma cortisol as described by its timing, timing relative to sleep, or amplitude was indistinguishable between women with ABC and age-matched controls (p's > 0.11, t-tests). There was, however, an aberrant spike of cortisol during the sleep of a subset of women, during which there was an eightfold increase in the amount of objectively measured wake time (p < 0.004, Wilcoxon Signed-Rank). This cortisol aberration was associated with cancer progression such that the larger the aberration, the shorter the disease-free interval (time from initial diagnosis to metastasis; r = -0.30, p = 0.004; linear regression). The same aberrant spike was present in a similar percent of women without ABC and associated with concomitant sleep disruption. A greater understanding of this sleep-related cortisol abnormality, possibly a vulnerability trait, is likely important in our understanding of individual variation in the progression of cancer.
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Affiliation(s)
- Jamie M Zeitzer
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, 94305, USA.
- Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, 3801 Miranda Avenue (151Y), Palo Alto, CA, 94304, USA.
| | - Bita Nouriani
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, 94305, USA
| | - Michelle B Rissling
- Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, 3801 Miranda Avenue (151Y), Palo Alto, CA, 94304, USA
- Durham VA Medical Center, Durham, NC, 27705, USA
| | - George W Sledge
- Department of Medicine/Oncology, Stanford University, Stanford, CA, 94305, USA
| | - Katherine A Kaplan
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, 94305, USA
| | - Linn Aasly
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, 94305, USA
- Columbia University, New York, NY, 10027, USA
| | - Oxana Palesh
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, 94305, USA
| | - Booil Jo
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, 94305, USA
| | - Eric Neri
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, 94305, USA
| | - Firdaus S Dhabhar
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, 94305, USA
| | - David Spiegel
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, 94305, USA
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Abstract
This study examined whether individuals with primary insomnia (PI) are more reactive to stress than good sleepers (GS). PI and GS (n = 20 per group), matched on gender and age, completed three nights of polysomnography. On the stress night, participants received a mild electric shock and were told they could receive additional shocks during the night. Saliva samples were obtained for analysis of cortisol and alpha amylase along with self-report and visual analog scales (VAS). There was very little evidence of increased stress on the stress night, compared to the baseline night. There was also no evidence of greater stress reactivity in the PI group for any sleep or for salivary measures. In the GS group, stress reactivity measured by VAS scales was positively associated with an increase in sleep latency in the experimental night on exploratory analyses. Individuals with PI did not show greater stress reactivity compared to GS.
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Affiliation(s)
- Philip R Gehrman
- a Department of Psychiatry Perelman School of Medicine at the University of Pennsylvania.,b Philadelphia Veterans Administration Medical Center
| | - Martica Hall
- c Sleep Medicine Institute and Department of Psychiatry , University of Pittsburgh School of Medicine
| | - Holly Barilla
- a Department of Psychiatry Perelman School of Medicine at the University of Pennsylvania
| | - Daniel Buysse
- c Sleep Medicine Institute and Department of Psychiatry , University of Pittsburgh School of Medicine
| | - Michael Perlis
- a Department of Psychiatry Perelman School of Medicine at the University of Pennsylvania
| | - Nalaka Gooneratne
- d Division of Geriatric Medicine Perelman School of Medicine at the University of Pennsylvania
| | - Richard J Ross
- a Department of Psychiatry Perelman School of Medicine at the University of Pennsylvania.,b Philadelphia Veterans Administration Medical Center
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Hori H, Koga N, Hidese S, Nagashima A, Kim Y, Higuchi T, Kunugi H. 24-h activity rhythm and sleep in depressed outpatients. J Psychiatr Res 2016; 77:27-34. [PMID: 26978182 DOI: 10.1016/j.jpsychires.2016.02.022] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 02/19/2016] [Accepted: 02/29/2016] [Indexed: 11/19/2022]
Abstract
Disturbances in sleep and circadian rest-activity rhythms are key features of depression. Actigraphy, a non-invasive method for monitoring motor activity, can be used to objectively assess circadian rest-activity rhythms and sleep patterns. While recent studies have measured sleep and daytime activity of depressed patients using wrist-worn actigraphy, the actigraphic 24-h rest-activity rhythm in depression has not been well documented. We aimed to examine actigraphically measured sleep and circadian rest-activity rhythms in depressed outpatients. Twenty patients with DSM-IV major depressive episode and 20 age- and sex-matched healthy controls participated in this study. Participants completed 7 consecutive days of all-day actigraphic activity monitoring while engaging in usual activities. For sleep parameters, total sleep time, wake after sleep onset, and sleep fragmentation index were determined. Circadian rhythms were estimated by fitting individual actigraphy data to a cosine curve of a 24-h activity rhythm using the cosinor method, which generated three circadian activity rhythm parameters, i.e., MESOR (rhythm-adjusted mean), amplitude, and acrophase. Subjective sleep was also assessed using a sleep diary and the Pittsburgh Sleep Quality Index. Patients showed significantly lower MESOR and more dampened amplitude along with significant sleep disturbances. Logistic regression analysis revealed that lower MESOR and more fragmented sleep emerged as the significant predictors of depression. Correlations between subjectively and actigraphically measured parameters demonstrated the validity of actigraphic measurements. These results indicate marked disturbances in sleep and circadian rest-activity rhythms of depression. By simultaneously measuring sleep and rest-activity rhythm parameters, actigraphy might serve as an objective diagnostic aid for depression.
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Affiliation(s)
- Hiroaki Hori
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, 187-8502, Japan; Department of Adult Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, 187-8553, Japan.
| | - Norie Koga
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, 187-8502, Japan
| | - Shinsuke Hidese
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, 187-8502, Japan
| | - Anna Nagashima
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, 187-8502, Japan
| | - Yoshiharu Kim
- Department of Adult Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, 187-8553, Japan
| | - Teruhiko Higuchi
- National Center of Neurology and Psychiatry, Tokyo, 187-8502, Japan
| | - Hiroshi Kunugi
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, 187-8502, Japan
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Recurrent short sleep, chronic insomnia symptoms and salivary cortisol: A 10-year follow-up in the Whitehall II study. Psychoneuroendocrinology 2016; 68:91-9. [PMID: 26963375 PMCID: PMC4862960 DOI: 10.1016/j.psyneuen.2016.02.021] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 02/19/2016] [Accepted: 02/22/2016] [Indexed: 02/03/2023]
Abstract
Although an association between both sleep duration and disturbance with salivary cortisol has been suggested, little is known about the long term effects of poor quality sleep on diurnal cortisol rhythm. The aim of this study was to examine the association of poor quality sleep, categorised as recurrent short sleep duration and chronic insomnia symptoms, with the diurnal release of cortisol. We examined this in 3314 participants from an occupational cohort, originally recruited in 1985-1989. Salivary cortisol was measured in 2007-2009 and six saliva samples were collected: (1) waking, (2) waking+0.5h, (3) +2.5h, (4) +8h, (5) +12h and (6) bedtime, for assessment of the cortisol awakening response and the diurnal slope in cortisol secretion. Participants with the first saliva sample collected within 15min of waking and not on steroid medication were examined. Short sleep duration (≤5h) and insomnia symptoms (Jenkins scale, highest quartile) were measured in 1997-1999, 2003-2004 and 2007-2009. Recurrent short sleep was associated with a flatter diurnal cortisol pattern. A steeper morning rise in cortisol was observed among those reporting chronic insomnia symptoms at three time points and among those reporting short sleep twice, compared to those who never reported sleep problems. Participants reporting short sleep on three occasions had higher levels of cortisol later in the day, compared to those never reporting short sleep, indicated by a positive interaction with hours since waking (β=0.02 (95% CI: 0.01, 0.03)). We conclude that recurrent sleep problems are associated with adverse salivary cortisol patterns throughout the day.
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Rabat A, Gomez-Merino D, Roca-Paixao L, Bougard C, Van Beers P, Dispersyn G, Guillard M, Bourrilhon C, Drogou C, Arnal PJ, Sauvet F, Leger D, Chennaoui M. Differential Kinetics in Alteration and Recovery of Cognitive Processes from a Chronic Sleep Restriction in Young Healthy Men. Front Behav Neurosci 2016; 10:95. [PMID: 27242464 PMCID: PMC4876616 DOI: 10.3389/fnbeh.2016.00095] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 05/02/2016] [Indexed: 01/01/2023] Open
Abstract
Chronic sleep restriction (CSR) induces neurobehavioral deficits in young and healthy people with a morning failure of sustained attention process. Testing both the kinetic of failure and recovery of different cognitive processes (i.e., attention, executive) under CSR and their potential links with subject's capacities (stay awake, baseline performance, age) and with some biological markers of stress and anabolism would be useful in order to understand the role of sleep debt on human behavior. Twelve healthy subjects spent 14 days in laboratory with 2 baseline days (B1 and B2, 8 h TIB) followed by 7 days of sleep restriction (SR1-SR7, 4 h TIB), 3 sleep recovery days (R1-R3, 8 h TIB) and two more ones 8 days later (R12-R13). Subjective sleepiness (KSS), maintenance of wakefulness latencies (MWT) were evaluated four times a day (10:00, 12:00 a.m. and 2:00, 4:00 p.m.) and cognitive tests were realized at morning (8:30 a.m.) and evening (6:30 p.m.) sessions during B2, SR1, SR4, SR7, R2, R3 and R13. Saliva (B2, SR7, R2, R13) and blood (B1, SR6, R1, R12) samples were collected in the morning. Cognitive processes were differently impaired and recovered with a more rapid kinetic for sustained attention process. Besides, a significant time of day effect was only evidenced for sustained attention failures that seemed to be related to subject's age and their morning capacity to stay awake. Executive processes were equally disturbed/recovered during the day and this failure/recovery process seemed to be mainly related to baseline subject's performance and to their capacity to stay awake. Morning concentrations of testosterone, cortisol and α-amylase were significantly decreased at SR6-SR7, but were either and respectively early (R1), tardily (after R2) and not at all (R13) recovered. All these results suggest a differential deleterious and restorative effect of CSR on cognition through biological changes of the stress pathway and subject's capacity (ClinicalTrials-NCT01989741).
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Affiliation(s)
- Arnaud Rabat
- Fatigue and Vigilance Unit, Department of Neurosciences and Operational Constraints, Armed Forces Biomedical Research Institute (IRBA)Brétigny-sur-Orge, France; VIFASOM team (EA 7330), University of Paris 5 DescartesParis, France
| | - Danielle Gomez-Merino
- Fatigue and Vigilance Unit, Department of Neurosciences and Operational Constraints, Armed Forces Biomedical Research Institute (IRBA)Brétigny-sur-Orge, France; VIFASOM team (EA 7330), University of Paris 5 DescartesParis, France
| | - Laura Roca-Paixao
- Fatigue and Vigilance Unit, Department of Neurosciences and Operational Constraints, Armed Forces Biomedical Research Institute (IRBA)Brétigny-sur-Orge, France; University of Paris 11Orsay, France
| | - Clément Bougard
- Fatigue and Vigilance Unit, Department of Neurosciences and Operational Constraints, Armed Forces Biomedical Research Institute (IRBA)Brétigny-sur-Orge, France; VIFASOM team (EA 7330), University of Paris 5 DescartesParis, France
| | - Pascal Van Beers
- Fatigue and Vigilance Unit, Department of Neurosciences and Operational Constraints, Armed Forces Biomedical Research Institute (IRBA)Brétigny-sur-Orge, France; VIFASOM team (EA 7330), University of Paris 5 DescartesParis, France
| | - Garance Dispersyn
- Fatigue and Vigilance Unit, Department of Neurosciences and Operational Constraints, Armed Forces Biomedical Research Institute (IRBA)Brétigny-sur-Orge, France; VIFASOM team (EA 7330), University of Paris 5 DescartesParis, France
| | - Mathias Guillard
- Fatigue and Vigilance Unit, Department of Neurosciences and Operational Constraints, Armed Forces Biomedical Research Institute (IRBA)Brétigny-sur-Orge, France; VIFASOM team (EA 7330), University of Paris 5 DescartesParis, France
| | - Cyprien Bourrilhon
- Department of Operational Environments, Armed Forces Biomedical Research Institute (IRBA) Brétigny-sur-Orge, France
| | - Catherine Drogou
- Fatigue and Vigilance Unit, Department of Neurosciences and Operational Constraints, Armed Forces Biomedical Research Institute (IRBA)Brétigny-sur-Orge, France; VIFASOM team (EA 7330), University of Paris 5 DescartesParis, France
| | - Pierrick J Arnal
- Fatigue and Vigilance Unit, Department of Neurosciences and Operational Constraints, Armed Forces Biomedical Research Institute (IRBA)Brétigny-sur-Orge, France; VIFASOM team (EA 7330), University of Paris 5 DescartesParis, France
| | - Fabien Sauvet
- Fatigue and Vigilance Unit, Department of Neurosciences and Operational Constraints, Armed Forces Biomedical Research Institute (IRBA)Brétigny-sur-Orge, France; VIFASOM team (EA 7330), University of Paris 5 DescartesParis, France
| | - Damien Leger
- VIFASOM team (EA 7330), University of Paris 5 DescartesParis, France; Alertness and Sleep Center, Hôtel Dieu de Paris, Public Assistance of Paris Hospitals, University of Paris 5 DescartesParis, France
| | - Mounir Chennaoui
- Fatigue and Vigilance Unit, Department of Neurosciences and Operational Constraints, Armed Forces Biomedical Research Institute (IRBA)Brétigny-sur-Orge, France; VIFASOM team (EA 7330), University of Paris 5 DescartesParis, France
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Abstract
Sleep disordered breathing (SDB) occurs in 0.6% to 15% of reproductive-aged women. Because of an overlap in symptoms of SDB and normal pregnancy findings, the diagnosis of SDB in pregnancy is challenging. The repetitive arousals, sleep fragmentation, and hypoxias experienced by patients with SDB lead to an increase in oxidative stress and inflammation. In the nonpregnant population SDB is associated with an increased risk of diabetes mellitus, heart disease, and stroke. Increasing evidence identifies an association between SDB in pregnancy and gestational diabetes, preeclampsia, and fetal growth abnormalities.
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Affiliation(s)
- Mary Ashley Cain
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of South Florida Morsani College of Medicine, 2 Tampa General Circle, 6th Floor, Tampa, FL 33606, USA.
| | - Judette M Louis
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of South Florida Morsani College of Medicine, 2 Tampa General Circle, 6th Floor, Tampa, FL 33606, USA; Department of Community and Family Health, College of Public Health, University of South Florida, 2 Tampa General Circle, 6th Floor, Tampa, FL 33606, USA
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67
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Sleep problems predict cortisol reactivity to stress in urban adolescents. Physiol Behav 2016; 155:95-101. [DOI: 10.1016/j.physbeh.2015.12.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 11/19/2015] [Accepted: 12/06/2015] [Indexed: 11/21/2022]
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68
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Abstract
Sleep and energy balance are essential for health. The two processes act in concert to regulate central and peripheral homeostasis. During sleep, energy is conserved due to suspended activity, movement, and sensory responses, and is redirected to restore and replenish proteins and their assemblies into cellular structures. During wakefulness, various energy-demanding activities lead to hunger. Thus, hunger promotes arousal, and subsequent feeding, followed by satiety that promotes sleep via changes in neuroendocrine or neuropeptide signals. These signals overlap with circuits of sleep-wakefulness, feeding, and energy expenditure. Here, we will briefly review the literature that describes the interplay between the circadian system, sleep-wake, and feeding-fasting cycles that are needed to maintain energy balance and a healthy metabolic profile. In doing so, we describe the neuroendocrine, hormonal/peptide signals that integrate sleep and feeding behavior with energy metabolism.
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Affiliation(s)
- Charu Shukla
- Department of Psychiatry, VA Boston Healthcare System, Harvard Medical School, West Roxbury, MA, USA
| | - Radhika Basheer
- Department of Psychiatry, VA Boston Healthcare System, Harvard Medical School, West Roxbury, MA, USA
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69
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Efficacy of sleep education program based on principles of cognitive behavioral therapy to alleviate workers’ distress. Sleep Biol Rhythms 2015. [DOI: 10.1007/s41105-015-0045-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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70
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D'Angelo V, Beccuti G, Berardelli R, Karamouzis I, Zichi C, Giordano R, Minetto MA, Maccario M, Ghigo E, Arvat E. Cushing's syndrome is associated with sleep alterations detected by wrist actigraphy. Pituitary 2015. [PMID: 26208446 DOI: 10.1007/s11102-015-0667-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND The association between the hypothalamic-pituitary-adrenal (HPA) axis and sleep is well described. It is also known that HPA axis disturbances have an effect on sleep. In fact, patients affected by Cushing's syndrome (CS) often complain about poor sleep quality. Our aim was to evaluate objective sleep quality and duration in patients with Cushing's syndrome in active phase, using wrist actigraphy. PATIENTS AND METHODS In 12 patients with active CS without ongoing specific therapy (11 F, 1 M; age 40.0 ± 10.9 years; BMI 28.4 ± 6.7 kg/m(2)) and 12 healthy control subjects (HS) (11 F, 1 M; age 44.0 ± 11.0 years; BMI 23.9 ± 4.2 kg/m(2)) an actigraphic evaluation was performed on 3 consecutive days under free living conditions. Objective measurement of sleep duration and quality was estimated by an actiwatch, which is a wristwatch-like device used to detect motor activity. RESULTS In CS patients, wrist actigraphy showed higher fragmented sleep (fragmentation index CS 16.2 ± 4.2, HS 13.0 ± 3.6; p = 0.034) and increased nocturnal motor activity (total activity score CS 8318 ± 4308, HS 4971 ± 2372; p = 0.020; mean activity score CS 8.7 ± 4.2, HS 5.4 ± 2.2; p = 0.030; mean score in active time CS 104.8 ± 39.2, HS 74.8 ± 23.1; p = 0.030). On the contrary, actual sleep time resulted similar in CS and HS. No correlation was found between sleep alterations and urinary free cortisol in patients. CONCLUSIONS The impaired actigraphic parameters described in our study suggest that hypercortisolism is associated with sleep alterations, which could contribute to the worsening of life quality and metabolic comorbidities associated with CS. These results have to be confirmed in a larger cohort of patients, using more accurate instruments for sleep assessment.
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Affiliation(s)
- Valentina D'Angelo
- Division of Oncologic Endocrinology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Guglielmo Beccuti
- Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Rita Berardelli
- Division of Oncologic Endocrinology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Ioannis Karamouzis
- Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Clizia Zichi
- Division of Oncologic Endocrinology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Roberta Giordano
- Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, Turin, Italy
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Marco Alessandro Minetto
- Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Mauro Maccario
- Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Ezio Ghigo
- Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Emanuela Arvat
- Division of Oncologic Endocrinology, Department of Medical Sciences, University of Turin, Turin, Italy.
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Sundararajan S, Muthukumar S, Rao SR. Relationship between depression and chronic periodontitis. J Indian Soc Periodontol 2015; 19:294-6. [PMID: 26229270 PMCID: PMC4520114 DOI: 10.4103/0972-124x.153479] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 02/05/2015] [Indexed: 11/17/2022] Open
Abstract
Background: Periodontitis is a chronic, multifactorial, polymicrobial disease causing inflammation in the supporting structures of the teeth. There is a plethora of nonoral risk factors which can be quoted to aid in the development of chronic periodontitis. According to WHO, depression is a common mental disorder that presents with depressed mood, loss of interest or pleasure, feelings of guilt, disturbed sleep or appetite, low energy and poor concentration. Depression is associated with negligent oral health care and another mechanism proposed disturbance in the hypothalamic-pituitary axis system and hypothalamic-pituitary-thyroid system, which can affect the periodontal status by affecting the immune system. Aim: The aim of this study was to assess the association between periodontal clinical parameters and depression rating. Materials and Methods: The study design is a case–control study with 35 patients each in case and control group. The periodontal parameters taken for measurement were probing depth and clinical attachment loss. Depression was calculated using Beck's depression scale. Statistical Analysis: The statistical analysis was performed by means of SPSS software (SPSS Inc., Chicago, IL, USA; version 17.0 under windows 2000). Student's t-test was used to determine the relationship between the clinical periodontal parameters and depression. Results: Self-reported scoring of depression by using Beck's depression inventory has shown that periodontal patients had a significantly higher total depression score than normal controls. Conclusion: This study reveals that there is a direct correlation between the severity of periodontal disease and the severity of depression in patients.
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Affiliation(s)
- Shiyamali Sundararajan
- Department of Periodontics, Sri Ramachandra University, Porur, Chennai, Tamil Nadu, India
| | | | - Suresh Ranga Rao
- Department of Periodontics, Sri Ramachandra University, Porur, Chennai, Tamil Nadu, India
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72
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Frequent nightmares are associated with blunted cortisol awakening response in women. Physiol Behav 2015; 147:233-7. [DOI: 10.1016/j.physbeh.2015.05.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Revised: 04/04/2015] [Accepted: 05/02/2015] [Indexed: 11/18/2022]
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SCHAAL KARINE, LE MEUR YANN, LOUIS JULIEN, FILLIARD JEANROBERT, HELLARD PHILIPPE, CASAZZA GRETCHEN, HAUSSWIRTH CHRISTOPHE. Whole-Body Cryostimulation Limits Overreaching in Elite Synchronized Swimmers. Med Sci Sports Exerc 2015; 47:1416-25. [PMID: 25314578 DOI: 10.1249/mss.0000000000000546] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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74
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Peifer C, Schächinger H, Engeser S, Antoni CH. Cortisol effects on flow-experience. Psychopharmacology (Berl) 2015; 232:1165-73. [PMID: 25304863 DOI: 10.1007/s00213-014-3753-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 09/15/2014] [Indexed: 12/17/2022]
Abstract
RATIONALE Stress affects flow-experience, but the mediating psychobiological mechanisms remain unknown. Previous studies showed an association between flow-experience and endogenous cortisol levels, suggesting an inverted, u-shaped relation between flow-experience and cortisol. However, these studies could not exclude effects of other stress factors. OBJECTIVES The aim of this experiment was, therefore, to test the isolated effect of cortisol on flow-experience, independent of concomitant physiological and psychological stress responses, via controlled administration of exogenous cortisol. METHODS Sixty-four young healthy subjects (32 males, 32 females) participated in the experiment. According to a double-blind, randomized, placebo-controlled, cross-over design, they received 20 mg oral cortisol on 1 day and placebo on the other day, respectively, with a time distance of 1 week between the experimental days. One hour after cortisol administration, participants engaged in the computer game Pacman. Pacman was delivered in five blocks of randomly differing difficulty levels. One block lasted 5 min. At the end of each block, participants rated flow-experience by the Flow Short Scale. Data was analyzed with hierarchical linear modeling. Subjects were not able to predict whether the pill they received contained cortisol or placebo. RESULTS Overall, results revealed a negative effect of oral 20 mg cortisol on flow-experience, with no differences between males and females. CONCLUSIONS This study is the first to show that exogenous cortisol in a dose corresponding to a severe stressor impairs flow-experience. The observed negative effect of high cortisol dosage on experienced flow underlines recent findings of an inverted u-shaped relationship between cortisol and flow.
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Affiliation(s)
- Corinna Peifer
- Department of Social and Organizational Psychology, Institute of Psychology, Leuphana University Lueneburg, Scharnhorststr. 1, 21335, Lueneburg, Germany,
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Rosen G, Harris AK, Liu M, Dreyfus J, Krueger J, Messinger YH. The effects of dexamethasone on sleep in young children with acute lymphoblastic leukemia. Sleep Med 2015; 16:503-9. [PMID: 25799940 DOI: 10.1016/j.sleep.2014.11.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Revised: 11/03/2014] [Accepted: 11/06/2014] [Indexed: 01/08/2023]
Abstract
PURPOSE Corticosteroids, which are a mainstay in the treatment of acute lymphoblastic leukemia (ALL), have a well-documented adverse effect on sleep. We sought to characterize the effects of dexamethasone on sleep over an entire 28-day treatment cycle using actigraphy, an objective measure of sleep. METHODS The sleep of 25 children aged 2-9 years (mean 4.5 years) with ALL treated with dexamethasone were evaluated during maintenance chemotherapy using a within-subject experimental design, actigraphy, and standardized questionnaires to assess sleep, sleep problems, and fatigue. RESULTS During the five days of dexamethasone treatment, sleep time increased during the night (535 vs. 498 min; p = 0.004) and daytime napping increased the following day (14 vs. 0 min; p = 0.002), and the number of wake episodes during the night was lower (14 vs. 20; p = ≤ 0.001). However, when assessed individually, sleep-onset time, efficiency, and wake after sleep onset during the night were unchanged during dexamethasone treatment; when the cumulative effect of all of these factors was assessed, there was a statistically and clinically significant increase in nighttime sleep duration during dexamethasone treatment. CONCLUSIONS During the five days of treatment with dexamethasone, an increase in nighttime sleep as well as daytime napping was observed in young children with ALL. The increases in sleep duration return to baseline one day after the discontinuation of dexamethasone.
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Affiliation(s)
- Gerald Rosen
- Sleep Medicine, Children's Hospitals and Clinics of Minnesota, St. Paul, MN, United States.
| | - Anne K Harris
- Pediatric Hematology/Oncology, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, United States
| | - Meixia Liu
- Research & Sponsored Programs, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, United States
| | - Jill Dreyfus
- Research & Sponsored Programs, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, United States
| | - James Krueger
- Sleep and Performance Research Center, Washington State University, Spokane, WA, United States
| | - Yoav H Messinger
- Pediatric Hematology/Oncology, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, United States
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Lemola S, Perkinson-Gloor N, Hagmann-von Arx P, Brand S, Holsboer-Trachsler E, Grob A, Weber P. Morning cortisol secretion in school-age children is related to the sleep pattern of the preceding night. Psychoneuroendocrinology 2015; 52:297-301. [PMID: 25553389 DOI: 10.1016/j.psyneuen.2014.12.007] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Revised: 12/04/2014] [Accepted: 12/05/2014] [Indexed: 02/03/2023]
Abstract
Sleep disturbance in childhood is common and a risk factor for poor mental health. Evidence indicates that disturbed sleep is associated with altered hypothalamic-pituitary-adrenal axis (HPAA) activity. Knowledge regarding the association between HPAA-activity and objective sleep measures particularly regarding sleep architecture in school-age children is missing. Sleep-electroencephalography was administered to 113 children aged 6-10 years (including 58 children born very preterm and 55 born at term) during one night at the children's homes and sleep duration, sleep continuity, and sleep architecture were assessed. To assess the cortisol awakening response at the following morning, cortisol secretion was measured at awakening, 10, 20, and 30min later. Regression analyses controlling child age, gender, prematurity status, and the awakening time revealed that morning cortisol secretion was negatively associated with sleep duration and slow wave sleep and positively associated with the relative amount of Stage 2 sleep during the preceding night. In addition, morning cortisol secretion linearly increased with age. In conclusion, associations of sleep disturbance with poor mental health may be confounded with altered HPAA-activity.
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Affiliation(s)
- Sakari Lemola
- Department of Psychology, University of Basel, Missionsstrasse 62, 4055 Basel, Switzerland.
| | - Nadine Perkinson-Gloor
- Department of Psychology, University of Basel, Missionsstrasse 62, 4055 Basel, Switzerland.
| | - Priska Hagmann-von Arx
- Department of Psychology, University of Basel, Missionsstrasse 62, 4055 Basel, Switzerland.
| | - Serge Brand
- Center for Affective, Stress and Sleep Disorders, Psychiatric Clinics of the University of Basel, Wilhelm Klein-Strasse 27, 4014 Basel, Switzerland; Department of Sport, Exercise and Health, Division of Sport Science, Faculty of Medicine, University of Basel, Birsstrasse 320 B, 4052 Basel, Switzerland.
| | - Edith Holsboer-Trachsler
- Center for Affective, Stress and Sleep Disorders, Psychiatric Clinics of the University of Basel, Wilhelm Klein-Strasse 27, 4014 Basel, Switzerland.
| | - Alexander Grob
- Department of Psychology, University of Basel, Missionsstrasse 62, 4055 Basel, Switzerland.
| | - Peter Weber
- Division of Neuropediatrics and Developmental Medicine, University Children's Hospital Basel, Spitalstrasse 33, 4056 Basel, Switzerland.
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van Dalfsen JH, Markus CR. Interaction between 5-HTTLPR genotype and cognitive stress vulnerability on sleep quality: effects of sub-chronic tryptophan administration. Int J Neuropsychopharmacol 2015; 18:pyu057. [PMID: 25644221 PMCID: PMC4360245 DOI: 10.1093/ijnp/pyu057] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Abundant evidence suggests that allelic variation in the serotonin transporter-linked polymorphic region (5-HTTLPR) influences susceptibility to stress and its affective consequences due to brain serotonergic vulnerability. Based on recent assumptions, the present study examined whether the 5-HTTLPR genotype may also interact with a vulnerability to chronic stress experience (conceptualized by trait neuroticism) in order to influence sleep quality and, additionally, whether this is influenced by brain serotonergic manipulations. METHODS In a well-balanced experimental design, homozygous S-allele (n = 57) and L-allele (n = 54) genotypes with high and low chronic stress vulnerability (neuroticism) were first assessed for general past sleep quality during a month before onset of the experiment. Then subjects were assessed for sleep quality following 7 days of tryptophan (3.0g/day) or placebo intake. RESULTS Although high neuroticism was significantly related to a higher frequency of stressful life events and daily hassles, it did not interact with the 5-HTTLPR genotype on general past sleep quality. However, as expected, a 7 day period of tryptophan administration was exclusively associated with better sleep quality scores in the S'/S' genotype with high trait neuroticism. CONCLUSIONS Current findings suggest that 5-HTTLPR does not directly interact with stress vulnerability in order to influence sleep quality. Instead, based on current and previous findings, it is suggested that the S'/S' 5-HTTLPR genotype promotes the risk for stress-related sleep disturbances because of an increased susceptibility to the depressogenic consequences of stress. Accordingly, by way of reducing depressive symptomatology, tryptophan augmentation may particularly improve sleep quality in stress-vulnerable individuals carrying the 5-HTTLPR S-allele.
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Affiliation(s)
- Jens H van Dalfsen
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University
| | - C Rob Markus
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University.
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Bassett SM, Lupis SB, Gianferante D, Rohleder N, Wolf JM. Sleep quality but not sleep quantity effects on cortisol responses to acute psychosocial stress. Stress 2015; 18:638-44. [PMID: 26414625 PMCID: PMC4914363 DOI: 10.3109/10253890.2015.1087503] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Given the well-documented deleterious health effects, poor sleep has become a serious public health concern and increasing efforts are directed toward understanding underlying pathways. One potential mechanism may be stress and its biological correlates; however, studies investigating the effects of poor sleep on a body's capacity to deal with challenges are lacking. The current study thus aimed at testing the effects of sleep quality and quantity on cortisol responses to acute psychosocial stress. A total of 73 college-aged adults (44 females) were investigated. Self-reported sleep behavior was assessed via the Pittsburgh Sleep Quality Index and salivary cortisol responses to the Trier Social Stress Test were measured. In terms of sleep quality, we found a significant three-way interaction, such that relative to bad sleep quality, men who reported fairly good or very good sleep quality showed blunted or exaggerated cortisol responses, respectively, while women's stress responses were less dependent on their self-reported sleep quality. Contrarily, average sleep duration did not appear to impact cortisol stress responses. Lastly, participants who reported daytime dysfunctions (i.e. having trouble staying awake or keeping up enthusiasm) also showed a trend to blunted cortisol stress responses compared to participants who did not experience these types of daytime dysfunctions. Overall, the current study suggests gender-specific stress reactivity dysfunctions as one mechanism linking poor sleep with detrimental physical health outcomes. Furthermore, the observed differential sleep effects may indicate that while the body may be unable to maintain normal hypothalamic-pituitary-adrenal functioning in an acute psychosocial stress situation after falling prey to low sleep quality, it may retain capacities to deal with challenges during extended times of sleep deprivation.
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Affiliation(s)
| | | | | | | | - Jutta M. Wolf
- Corresponding author and person to whom reprint requests should be addressed: Jutta M. Wolf, Ph.D., Brandeis University, 415 South St., MS 062, Waltham, MA 02453; , Phone: 781-736-3297, Fax: 781-736-3291
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Sniecinska-Cooper AM, Shah AJ, Dimitriou D, Iles RK, Butler SA, Bayford R. Determination of urinary cortisol, cortisone and 6-sulfatoxymelatonin using dilute and shoot ultra-high pressure liquid chromatography–tandem mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci 2015; 978-979:18-23. [DOI: 10.1016/j.jchromb.2014.11.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Revised: 11/17/2014] [Accepted: 11/20/2014] [Indexed: 11/30/2022]
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Sniecinska-Cooper AM, Iles RK, Butler SA, Jones H, Bayford R, Dimitriou D. Abnormal secretion of melatonin and cortisol in relation to sleep disturbances in children with Williams syndrome. Sleep Med 2015; 16:94-100. [DOI: 10.1016/j.sleep.2014.09.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Revised: 08/25/2014] [Accepted: 09/01/2014] [Indexed: 12/31/2022]
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Kim TW, Jeong JH, Hong SC. The impact of sleep and circadian disturbance on hormones and metabolism. Int J Endocrinol 2015; 2015:591729. [PMID: 25861266 PMCID: PMC4377487 DOI: 10.1155/2015/591729] [Citation(s) in RCA: 118] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Revised: 02/24/2015] [Accepted: 02/24/2015] [Indexed: 01/05/2023] Open
Abstract
The levels of several hormones fluctuate according to the light and dark cycle and are also affected by sleep, feeding, and general behavior. The regulation and metabolism of several hormones are influenced by interactions between the effects of sleep and the intrinsic circadian system; growth hormone, melatonin, cortisol, leptin, and ghrelin levels are highly correlated with sleep and circadian rhythmicity. There are also endogenous circadian mechanisms that serve to regulate glucose metabolism and similar rhythms pertaining to lipid metabolism, regulated through the actions of various clock genes. Sleep disturbance, which negatively impacts hormonal rhythms and metabolism, is also associated with obesity, insulin insensitivity, diabetes, hormonal imbalance, and appetite dysregulation. Circadian disruption, typically induced by shift work, may negatively impact health due to impaired glucose and lipid homeostasis, reversed melatonin and cortisol rhythms, and loss of clock gene rhythmicity.
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Affiliation(s)
- Tae Won Kim
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Suwon, Seoul 442723, Republic of Korea
| | - Jong-Hyun Jeong
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Suwon, Seoul 442723, Republic of Korea
- *Jong-Hyun Jeong:
| | - Seung-Chul Hong
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Suwon, Seoul 442723, Republic of Korea
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82
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Stackhouse-Lawson KR, Tucker CB, Calvo-Lorenzo MS, Mitloehner FM. Effects of growth-promoting technology on feedlot cattle behavior in the 21 days before slaughter. Appl Anim Behav Sci 2015. [DOI: 10.1016/j.applanim.2014.11.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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83
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Sladek MR, Doane LD. Daily Diary Reports of Social Connection, Objective Sleep, and the Cortisol Awakening Response During Adolescents’ First Year of College. J Youth Adolesc 2014; 44:298-316. [DOI: 10.1007/s10964-014-0244-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Accepted: 12/15/2014] [Indexed: 10/24/2022]
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84
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Manzar MD, Zannat W, Hussain ME. Sleep and physiological systems: a functional perspective. BIOL RHYTHM RES 2014. [DOI: 10.1080/09291016.2014.966504] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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85
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Patacchioli FR, Tabarrini A, Ghiciuc CM, Dima-Cozma LC, Prete A, Bianchini C, Nicoletti F, Gozal D, Villa MP. Salivary biomarkers of obstructive sleep apnea syndrome in children. Pediatr Pulmonol 2014; 49:1145-52. [PMID: 24474530 DOI: 10.1002/ppul.22972] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 11/03/2013] [Indexed: 02/05/2023]
Abstract
OBJECTIVES The present pilot study was performed to evaluate the HPA axis and ANS activity by measuring salivary cortisol and α-amylase diurnal trajectory and production, respectively, in mild or moderate-to-severe (MS) OSA-affected, but otherwise healthy, children. Moreover, a correlative analysis was performed between the salivary biomarker concentrations and the PSG variables characterizing the OSA severity. METHODS We studied 27 consecutive OSA patients (13 mild OSA; 14 MS OSA) and seven healthy children who were enrolled as controls by collecting salivary samples and measuring cortisol and α-amylase levels using enzyme-linked bioassays. RESULTS Compared with controls, both mild and MS OSA children showed: (1) increased salivary cortisol diurnal production, (2) maintenance of the physiological circadian activity of the HPA axis, and (3) no changes in α-amylase diurnal trajectory and production. In addition, morning salivary cortisol concentrations was negatively associated with the disease severity in the MS OSA group. CONCLUSIONS OSA is associated with dysregulation of the HPA axis activity in children, the latter potentially underlying some of the adverse consequences of the disease.
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Affiliation(s)
- Francesca R Patacchioli
- Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome, Rome, Italy
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86
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Abstract
BACKGROUND AND OBJECTIVES Environmental factors such as serious trauma or abuse and related stress can lead to nightmares or night terrors. Being bullied can be very distressing for children, and victims display long-term social, psychological, and health consequences. Unknown is whether being bullied by peers may increase the risk for experiencing parasomnias such as nightmares, night terrors, or sleepwalking. METHODS A total of 6796 children of the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort were interviewed at elementary school age (8 and 10 years) about bullying experiences with a previously validated bullying interview and at secondary school age (12.9 years) about parasomnias such as nightmares, night terrors and sleepwalking by trained postgraduate psychologists. RESULTS Even after adjusting for pre-existing factors related to bullying and parasomnias, being bullied predicted having nightmares (8 years odds ratio [OR], 1.23; 95% confidence interval [CI], 1.05-1.44; 10 years OR, 1.62; 95% CI, 1.35-1.94) or night terrors (8 years OR, 1.39; 95% CI, 1.10-1.75; 10 years OR, 1.53; 95% CI, 1.18-1.98) at age 12 to 13 years. Especially being a chronic victim was associated with both nightmares (OR, 1.82; 95% CI, 1.46-2.27) and night terrors (OR, 2.01; 95% CI, 1.48-2.74). Being a bully/victim also increased the risk for any parasomnia at ages 8 or 10 years (8 years OR, 1.42; 95% CI, 1.08-1.88; 10 years OR, 1.75; 95% CI, 1.30-2.36). In contrast, bullies had no increased risk for any parasomnias. CONCLUSIONS Being bullied increases the risk for having parasomnias. Hence, parents, teachers, school counselors, and clinicians may consider asking about bullying experiences if a child is having parasomnias.
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Affiliation(s)
- Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, United Kingdom, and Division of Mental Health and Wellbeing, University of Warwick Medical School, Coventry, United Kingdom
| | - Suzet Tanya Lereya
- Department of Psychology, University of Warwick, Coventry, United Kingdom, and
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87
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Hatzinger M, Brand S, Perren S, Von Wyl A, Stadelmann S, von Klitzing K, Holsboer-Trachsler E. In pre-school children, sleep objectively assessed via actigraphy remains stable over 12 months and is related to psychological functioning, but not to cortisol secretion. J Psychiatr Res 2014; 55:22-8. [PMID: 24814637 DOI: 10.1016/j.jpsychires.2014.04.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Revised: 03/22/2014] [Accepted: 04/07/2014] [Indexed: 01/13/2023]
Abstract
STUDY OBJECTIVES Studies of the long-term stability of sleep in pre-schoolers are scarce. The aim of the present study was to investigate objectively assessed sleep via actigraphy in pre-schoolers longitudinally, and to predict sleep, psychological functioning and cortisol secretion prospectively as a function of sleep 12 months earlier. METHOD A total of 73 pre-schoolers (mean age: 5.45 years; 53% females) were assessed again after 12 (mean age: 6.4 years). Sleep-actigraphy recordings were performed, saliva cortisol was analysed, and parents and experts rated children's psychological functioning. RESULTS Longitudinally, poor sleep at age 5.45 years was associated with poor sleep and internalizing and peer problems but not with externalizing problems and hyperactivity, and cortisol secretion 12 months later. At age 6.4 years and cross-sectionally, poor sleep was concurrently associated with greater psychological difficulties and increased cortisol secretion. CONCLUSION In pre-schoolers, poor sleep objectively assessed at age five was associated with psychological difficulties and poor sleep as assessed via actigraph and one year later. Results indicate that in pre-schoolers sleep remains stable over a 12-mont interval. Pre-schoolers with poor sleep appear to be at risk for developing further psychological difficulties.
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Affiliation(s)
- Martin Hatzinger
- Psychiatric Services Solothurn, Department of Adult Psychiatry, Solothurn, Switzerland; Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric Clinics of the University of Basel, Switzerland
| | - Serge Brand
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric Clinics of the University of Basel, Switzerland; Department of Sport, Exercise and Health, Division of Sport Science, University of Basel, Basel, Switzerland.
| | - Sonja Perren
- University of Konstanz and Thurgau, University of Teacher Education, Switzerland
| | - Agnes Von Wyl
- Institute of Psychology, University of Zurich, Switzerland
| | - Stephanie Stadelmann
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University of Leipzig, Germany
| | - Kai von Klitzing
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University of Leipzig, Germany
| | - Edith Holsboer-Trachsler
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric Clinics of the University of Basel, Switzerland
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88
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Le Dantec Y, Hache G, Guilloux JP, Guiard BP, David DJ, Adrien J, Escourrou P. NREM sleep hypersomnia and reduced sleep/wake continuity in a neuroendocrine mouse model of anxiety/depression based on chronic corticosterone administration. Neuroscience 2014; 274:357-68. [PMID: 24909899 DOI: 10.1016/j.neuroscience.2014.05.050] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Revised: 05/22/2014] [Accepted: 05/23/2014] [Indexed: 01/01/2023]
Abstract
Sleep/wake disorders are frequently associated with anxiety and depression and to elevated levels of cortisol. Even though these alterations are increasingly sought in animal models, no study has investigated the specific effects of chronic corticosterone (CORT) administration on sleep. We characterized sleep/wake disorders in a neuroendocrine mouse model of anxiety/depression, based on chronic CORT administration in the drinking water (35 μg/ml for 4 weeks, "CORT model"). The CORT model was markedly affected during the dark phase by non-rapid eye movement sleep (NREM) increase without consistent alteration of rapid eye movement (REM) sleep. Total sleep duration (SD) and sleep efficiency (SE) increased concomitantly during both the 24h and the dark phase, due to the increase in the number of NREM sleep episodes without a change in their mean duration. Conversely, the total duration of wake decreased due to a decrease in the mean duration of wake episodes despite an increase in their number. These results reflect hypersomnia by intrusion of NREM sleep during the active period as well as a decrease in sleep/wake continuity. In addition, NREM sleep was lighter, with an increased electroencephalogram (EEG) theta activity. With regard to REM sleep, the number and the duration of episodes decreased, specifically during the first part of the light period. REM and NREM sleep changes correlated respectively with the anxiety and the anxiety/depressive-like phenotypes, supporting the notion that studying sleep could be of predictive value for altered emotional behavior. The chronic CORT model in mice that displays hallmark characteristics of anxiety and depression provides an insight into understanding the changes in overall sleep architecture that occur under pathological conditions.
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Affiliation(s)
- Y Le Dantec
- Univ Paris-Sud, EA3544, Faculté de Pharmacie, 92296 Châtenay-Malabry cedex, France.
| | - G Hache
- Univ Paris-Sud, EA3544, Faculté de Pharmacie, 92296 Châtenay-Malabry cedex, France
| | - J P Guilloux
- Univ Paris-Sud, EA3544, Faculté de Pharmacie, 92296 Châtenay-Malabry cedex, France
| | - B P Guiard
- Univ Paris-Sud, EA3544, Faculté de Pharmacie, 92296 Châtenay-Malabry cedex, France
| | - D J David
- Univ Paris-Sud, EA3544, Faculté de Pharmacie, 92296 Châtenay-Malabry cedex, France
| | - J Adrien
- UMR975, CRicm - INSERM/CNRS/UPMC, Neurotransmetteurs et Sommeil, Faculté de Médecine Pitié-Salpêtrière, Université Pierre et Marie Curie - Paris VI, 91 boulevard de l'Hôpital, 75013 Paris, France
| | - P Escourrou
- Univ Paris-Sud, EA3544, Faculté de Pharmacie, 92296 Châtenay-Malabry cedex, France; Assistance Publique-Hôpitaux de Paris, Hôpital Antoine Béclère, Département de Physiologie, Centre de Médecine du Sommeil, 92141 Clamart cedex, France
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89
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The cortisol awakening response – Applications and implications for sleep medicine. Sleep Med Rev 2014; 18:215-24. [DOI: 10.1016/j.smrv.2013.05.001] [Citation(s) in RCA: 107] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Revised: 05/01/2013] [Accepted: 05/01/2013] [Indexed: 11/22/2022]
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90
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Hosono T, Homma M, Satoh M, Kohda Y. Variables influencing patient satisfaction for hypnotics: difference between zolpidem and brotizolam. J Clin Pharm Ther 2014; 39:507-10. [PMID: 24828966 DOI: 10.1111/jcpt.12174] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2011] [Accepted: 04/15/2014] [Indexed: 11/29/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE The pharmacokinetics of zolpidem and brotizolam is affected by gender and age, that is, increased clearance in males taking zolpidem and younger subjects taking brotizolam. The purpose of this study was to determine the variables including gender and age influencing patient satisfaction for hypnotics, zolpidem and brotizolam. METHODS The study included 329 patients who were treated with zolpidem (n = 172) and brotizolam (n = 157) for insomnia. Patients were interviewed to evaluate individual satisfaction and drug efficacy. The factors associated with dissatisfaction of zolpidem and brotizolam were identified using multiple logistic analysis. RESULTS AND DISCUSSION Of the participating patients, 40 (23%) and 41 (26%) complained of dissatisfaction with zolpidem and brotizolam, respectively. An insufficient amount of sleep (<6 h) and the number of awakenings were common factors cited for dissatisfaction for both drugs. Males were found to report a higher rate of dissatisfaction for zolpidem, whereas patients younger than 65 years and those receiving corticosteroid therapy reported a higher rate of dissatisfaction with brotizolam. WHAT IS NEW AND CONCLUSION These results suggested that patient satisfaction was different between zolpidem and brotizolam in terms of gender for zolpidem and age and corticosteroid co-administration for brotizolam, which could be used to help choose a better drug among the two in patients with insomnia.
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Affiliation(s)
- T Hosono
- Department of Pharmaceutical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan
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91
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Bright MA, Frick JE, Out D, Granger DA. Individual differences in the cortisol and salivary α-amylase awakening responses in early childhood: relations to age, sex, and sleep. Dev Psychobiol 2014; 56:1300-15. [PMID: 24604597 DOI: 10.1002/dev.21209] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Accepted: 01/27/2014] [Indexed: 12/28/2022]
Abstract
Recent studies have examined post-waking changes in cortisol as a marker of HPA functioning, but questions remain about the stability of this response, as well as its relation to sleep and other ANS markers. The purposes of this study were to a) examine the presence and developmental changes in the cortisol awakening response (CAR) and salivary α-amylase awakening (sAA-AR) in a toddler sample and b) determine whether and how sleep relates to these responses in this age group. We measured cortisol and sAA upon awakening (and 30 min post-waking) and sleep characteristics using actigraphy (e.g., total sleep time, sleep efficiency, number of awakenings) in toddlers (N = 47; 36% female, ages 12-24 months). Forty-six percent of toddlers demonstrated a CAR and 52% demonstrated a sAA-AR. Strength of either response did not change linearly with age. Additionally, likelihood of demonstrating the CAR and sAA-AR was unrelated to age, sex, awakening time, time between samples, and time since feeding. Higher waking cortisol levels were associated with a shorter total sleep time and an earlier awakening. No associations were observed between sleep characteristics and the sAA-AR, ps > .05. Our findings suggest that these awakening responses function independently of sleep in toddlers. Additionally, the lack of change in percentage of children showing a CAR or sAA-AR across these ages suggests that these responses are stable and not emerging reliably across the second year of life.
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Affiliation(s)
- Melissa A Bright
- Institute for Child Health Policy, University of Florida, Gainesville, FL
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92
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Vargas I, Lopez-Duran N. Dissecting the impact of sleep and stress on the cortisol awakening response in young adults. Psychoneuroendocrinology 2014; 40:10-6. [PMID: 24485471 DOI: 10.1016/j.psyneuen.2013.10.009] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Revised: 10/18/2013] [Accepted: 10/18/2013] [Indexed: 11/30/2022]
Abstract
Cortisol rises precipitously upon awakening, in what has been called the cortisol awakening response (CAR). Atypical CARs have been linked to a number of negative health outcomes. Yet, our understanding of the possible mechanisms creating these associations remains unclear. Both stress and sleep can influence CAR, and may potentially explain its links to health. However, these factors also impact each other, and their influence on CAR has rarely been studied simultaneously. In order to differentiate their effects, this study examined the impact of daily life hassles, anticipatory stress, and subjectively reported sleep on CAR among 58 college students. Self-reported stress and sleep, as well as salivary cortisol (collected during the first hour after awakening) were obtained across two consecutive days. Total sleep time predicted CAR magnitude, but daily hassles and anticipatory stress did not after accounting for the effect of sleep. Lower total sleep time was associated with lower awakening cortisol and greater CAR. These results provide further evidence for the impact of sleep insufficiency on CAR, and suggest future efforts to use CAR as a stress biomarker should take the impact of sleep into consideration.
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Affiliation(s)
- Ivan Vargas
- Department of Psychology, University of Michigan, Ann Arbor, MI, United States.
| | - Nestor Lopez-Duran
- Department of Psychology, University of Michigan, Ann Arbor, MI, United States
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93
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Izci-Balserak B, Pien GW. The relationship and potential mechanistic pathways between sleep disturbances and maternal hyperglycemia. Curr Diab Rep 2014; 14:459. [PMID: 24398662 PMCID: PMC4065785 DOI: 10.1007/s11892-013-0459-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
This paper reviews recent work investigating the influence of sleep disturbances on maternal hyperglycemia, particularly gestational diabetes mellitus (GDM). The incidence and prevalence of hyperglycemia are increasing worldwide, which is cause for concern because GDM and even mild hyperglycemia are associated with adverse pregnancy outcomes. A better understanding of sleep-related risk factors for maternal hyperglycemia is an important health matter. Evidence demonstrates associations between sleep disturbances, especially sleep-disordered breathing, and hyperglycemia, but causal effects and the underlying mechanisms linking these conditions have not been fully elucidated. Subjective sleep assessments show associations between sleep disturbances and maternal hyperglycemia. There are, however, few studies using objective measures to support these findings. Large prospective studies are required to examine causal relationships between sleep disturbances and maternal hyperglycemia. There is also a need for smaller mechanistic studies to understand the pathophysiology. Furthermore, interventional studies are required to address whether improvement of sleep parameters can prevent/decrease the risk of developing maternal hyperglycemia. Taken together, the data suggests that sleep disturbances during pregnancy are important to identify and manage in order to minimize maternal hyperglycemia and GDM, and improve maternal and fetal well-being.
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Affiliation(s)
- Bilgay Izci-Balserak
- Center for Sleep and Circadian Neurobiology, Perelman School of Medicine, University of Pennsylvania, 3624 Market Street, Suite 205, Philadelphia, PA, 19104, USA,
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94
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Palagini L, Tani C, Mauri M, Carli L, Vagnani S, Bombardieri S, Gemignani A, Mosca M. Sleep disorders and systemic lupus erythematosus. Lupus 2014; 23:115-23. [DOI: 10.1177/0961203313518623] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Objective Sleep disturbances are often seen in rheumatic diseases, including systemic lupus erythematosus (SLE). However, the prevalence of sleep disorders in SLE as well as the contributing factors to their occurrence remain poorly understood. The aim of this paper is to review the clinical and psychobiological data on the relationship between sleep disturbances and SLE. Method We performed a systematic search of MEDLINE, EMBASE and PsychINFO, using MeSH headings and keywords for “sleep disorders” and “SLE.” Results Nine studies reporting the relationship between sleep disorders and SLE were found. Prevalence rates of sleep disorders ranged between 55% and 85%; differences in assessment techniques appeared to be a major source of this variability. In the majority of the studies an association between sleep disorders and disease activity, pain and fatigue has been reported. Psychosocial variables, depression, steroid use, and the role that sleep disruption has on pain, inflammation and cytokines, have been hypothesized as possible psychobiological factors. Conclusions Sleep disorders appear to occur in more than half of patients with SLE and appear to be associated with disease activity. Pain and fatigue are also related to sleep disorders. Among the hypotheses on the possible mechanisms underlining the association between sleep disorders and SLE, psychosocial/psychological factors, especially depression, were the most frequently reported.
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Affiliation(s)
- L Palagini
- Psychiatry Unit, University of Pisa, Pisa, Italy
| | - C Tani
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - M Mauri
- Psychiatry Unit, University of Pisa, Pisa, Italy
| | - L Carli
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - S Vagnani
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - S Bombardieri
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - A Gemignani
- Department of Surgery, Medical, Molecular & Critical Area Pathology, University of Pisa, Pisa, Italy
| | - M Mosca
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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95
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Abstract
AbstractBrain activation patterns and mental, electrophysiological, and neurobiological features of rapid eye movement (REM) sleep suggest more functions than only elaborative encoding. Hence, the periodic occurrence of REM sleep episodes and dreaming may be regarded as a recurrent adaptive interference, which incorporates recent memories into a broader vital context comprising emotions, basic needs and individual genetic traits.
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96
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Hadlow NC, Brown S, Wardrop R, Henley D. The effects of season, daylight saving and time of sunrise on serum cortisol in a large population. Chronobiol Int 2013; 31:243-51. [PMID: 24156521 DOI: 10.3109/07420528.2013.844162] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Cortisol is critical for maintenance of health and homeostasis and factors affecting cortisol levels are of clinical importance. There is conflicting information about the effects of season on morning cortisol and little information on the effects of sunlight on population cortisol assessment. The aim of this study was to assess whether changes in median serum cortisol occurred in a population in conjunction with changing seasons, daylight saving time (DST) or time of sunrise. We analysed serum cortisol results (n = 27,569) from a single large laboratory over a 13-year period. Subjects with confounding medications or medical conditions were excluded and data analysed in 15-minute intervals. We assessed the influence of traditional seasons, seasons determined by equinox/solstice, DST and time of sunrise on median cortisol. The median time of cortisol collection did not vary significantly between seasons. Using traditional seasons, median cortisol was lowest in summer (386 nmol/L) and spring (384 nmol/L) with higher cortisol in autumn (406 nmol/L) and winter (414 nmol/L). Median cortisol was lowest in the summer solstice quarter with significant comparative increases in the spring equinox quarter (3.1%), the autumn equinox quarter (4.5%) and the winter solstice quarter (8.6%). When cortisol was modelled against time, with adjustment for actual sunrise time on day of collection, for each hour delay in sunrise there was a 4.8% increase in median cortisol (95% CI: 3.9-5.7%). In modelling to explain the variation in cortisol over the morning, sunrise time was better than season in explaining seasonal effects. A subtle cyclic pattern in median cortisol also occurred throughout the months of the year. A 3-year trial of DST allowed comparison of cortisol in DST and non DST periods, when clock time differed by one hour. There was modest evidence of a difference in acrophase between DST and non DST cortisol (p = 0.038), with DST peak cortisol estimated to occur 58 minutes later than non-DST peak. In summary, we found that time of sunrise and time of cortisol collection were the most important factors influencing median cortisol. For each hour later that the sun rose there was an almost 5% increase in median cortisol. There was significant seasonal variability with lowest cortisol noted in summer coinciding with the earliest sunrise time. This is an important finding which is consistent with the understanding that light is the major zeitgeber in entrainment of the human circadian cortisol rhythm. Our data suggest this rhythm is resistant to the arbitrary changes in clock time with daylight saving.
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Affiliation(s)
- Narelle C Hadlow
- Department of Clinical Biochemistry, PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre , Nedlands, Western Australia , Australia
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97
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Ferini-Strambi L, Galbiati A, Marelli S. Sleep microstructure and memory function. Front Neurol 2013; 4:159. [PMID: 24130550 PMCID: PMC3795358 DOI: 10.3389/fneur.2013.00159] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Accepted: 09/26/2013] [Indexed: 11/13/2022] Open
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98
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Abstract
Sleep is a complex biological process that involves cyclic changes of brain activity. The smooth transition between wakefulness and sleep and cyclic succession of sleep stages depend on the function of numerous neurotransmitters that reciprocally influence each other. For this reason sleep is a very sensitive biomarker of brain functioning. This article provides an overview of sleep changes in depression, mechanisms involved in sleep regulation and pathophysiology underlying depression, studies on sleep as a biomarker for depression, effects of antidepressants on sleep EEG, and studies in depression with the use of quantitative sleep EEG analysis. Research on sleep in depression has provided several valuable biomarkers that are related to increased risk for depression, show worsening during depressive episode, and are related to treatment outcome and relapse risk during remission phase. Among many sleep parameters, increased REM density and diminished delta sleep ratio deserve special interest. Sleep studies are also an important research tool for antidepressant drug development. However, due to sensitivity of sleep parameters to pharmacological interventions, the patients have to be investigated before the start of pharmacological treatment or after washout from the antidepressant drug, to obtain reliable data on disease-related biological processes from polysomnography.
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Affiliation(s)
- Adam Wichniak
- Third Department of Psychiatry, Institute of Psychiatry and Neurology , Warsaw , Poland
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99
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HANSEN MV, MADSEN MT, WILDSCHIØDTZ G, ROSENBERG J, GÖGENUR I. Sleep disturbances and changes in urinary 6-sulphatoxymelatonin levels in patients with breast cancer undergoing lumpectomy. Acta Anaesthesiol Scand 2013; 57:1146-53. [PMID: 23848183 DOI: 10.1111/aas.12157] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND Sleep disturbances and changes in self-reported discomfort and melatonin secretion are common in the post-operative period. We aimed to study the distribution of sleep stages in the perioperative period and evaluate changes in secretion of the melatonin metabolite aMT6s and subjective parameters of sleepiness, pain, general well-being and fatigue in patients undergoing surgery for breast cancer. METHODS Twelve patients, 30-70 years, undergoing lumpectomy were included. Polysomnography was performed the night before surgery (PREOP), the night after (PO1) and 14 days after (PO14). Recordings were scored as awake, light-sleep, slow-wave sleep and rapid-eye-movement (REM) sleep. Sleep stages were analysed as % of total sleep time (TST). Self-reported discomfort was assessed using questions about the level of fatigue, well-being, pain and sleepiness. Urinary aMT6s was measured by radioimmunoassay. RESULTS There was significantly decreased REM sleep on PO1 (5.9% of TST) compared with PREOP (18.7% of TST) (P < 0.005). An increase in light sleep was observed on PO1 (68.4% of TST) compared with PREOP (55.0% of TST) (P < 0.05). No significant changes in TST, sleep latency, sleep period or total time awake were found. The observed sleep changes were normalised after 2 weeks. No significant changes were found in pain, well-being, fatigue or sleepiness. Night secretion of aMT6s showed a trend towards a decrease from PREOP to PO1 (P = 0.09) and normalisation on PO14 (P = 0.27 between PREOP and PO14). CONCLUSION Patients with breast cancer undergoing lumpectomy had significantly disturbed sleep architecture the night after surgery, and these changes were normalised after 2 weeks.
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Affiliation(s)
| | | | - G. WILDSCHIØDTZ
- Rehabilitation- and Research Centre for Torture Victims; Copenhagen; Denmark
| | - J. ROSENBERG
- Department of Surgery; Herlev Hospital; University of Copenhagen; Copenhagen; Denmark
| | - I. GÖGENUR
- Department of Surgery; Herlev Hospital; University of Copenhagen; Copenhagen; Denmark
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Persson Waye K, Elmenhorst EM, Croy I, Pedersen E. Improvement of intensive care unit sound environment and analyses of consequences on sleep: an experimental study. Sleep Med 2013; 14:1334-40. [PMID: 24095263 DOI: 10.1016/j.sleep.2013.07.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Revised: 07/19/2013] [Accepted: 07/26/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Uninterrupted sleep is of vital importance for restoration and regaining health. In intensive care units (ICUs) where recovering and healing is crucial, patients' sleep often is fragmented and disturbed due to noise from activities from oneself, other patients, and alarms. The aim of our study was to explore if sleep could be improved by modifying the sound environment in a way that is practically feasible in ICUs. METHODS We studied the effects of originally recorded ICU noise and peak reduced ICU noise on sleep in healthy male participants. Sleep was registered with polysomnography (PSG) during four nights: one adaptation night, one reference (REF) night, and the two exposed nights with similar equivalent sound levels (47dB LAeq) but different maximum sound levels (56- vs 64-dB LAFmax). The participants answered questionnaires and saliva cortisol was sampled in the morning. RESULTS During ICU exposure nights, sleep was more fragmented with less slow-wave sleep (SWS), more arousals, and more time awake. The effects of reduced maximum sound level were minor. The subjective data supported the polysomnographic findings, though cortisol levels were not significantly affected by the exposure conditions. CONCLUSIONS Noise in ICUs impairs sleep and the reduction of maximal A-weighted levels from 64 to 56dB is not enough to have a clear improved effect on sleep quality.
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Affiliation(s)
- Kerstin Persson Waye
- Department of Occupational and Environmental Medicine, Gothenburg University, Medicinaregatan 16, 405 30 Göteborg, Sweden.
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